Deb Haley, Medicare Insurance Broker
Deb Haley
Medicare Broker Licensed in MA, CT, FL, ME, MN, NC, NH, NJ, RI, SC, TN, VT and WY
Contact Details
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Location
Tewksbury, MA
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Phone
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Website
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LinkedIn
About Me
Deb provides personalized professional one-on-one help with comparing your Medicare plan options, choosing a plan that meets your needs and budget, and enrolling in the plan of your choice.
Q&A with Deb Haley
I'm worried about the 'donut hole' in my Part D plan. How do I manage my medication costs once I enter it?
Answer: Good news! The coverage gap stage of prescription coverage, also known as the donut hole, was eliminated in 2025. There is now a $2,000 annual maximum out of pocket for your drug copays, after which you pay $0 copay for your medications for the remainder of the calendar year.
My diabetes medication is super expensive, and I've heard horror stories about Part D not covering what people need. Should I go standalone Part D or get it through a Medicare Advantage plan?
Answer: The drug formulary for each of the carriers is typically the same whether the medications are bundled in on their Medicare Advantage plan offering or on a standalone part D plan that they offer. The difference in price is that with the Medicare Advantage plan the prescription coverage is bundled in and there is no additional premium. The standalone Part D plans have a monthly premium that you pay in addition to your annual drug deductible s and copays. It would make sense to look at both options to see if there is a significant difference in price either way. The choice to go on a separate Part D plan may also be influenced by whether or not all of your medical providers are in network for a particular Medicare Advantage plan.
How does Medicare handle coverage for experimental treatments or clinical trials?
Answer: Medicare typically doesn't cover experimental treatments, however it may cover certain testing required while the experimental treatment is going on but that would likely need prior authorization.
Can you explain what "creditable coverage" means and when it applies?
Answer: Creditable coverage is health insurance and prescription drug coverage that is as good or better than what is offered through original Medicare. If you have creditable coverage through an employer plan then you can delay in rolling in Medicare and avoid the late enrollment penalties.
My pharmacist mentioned the Medicare "donut hole" is going away in 2025. What does that actually mean for me?
Answer: Starting in January of 2025 there is no longer a coverage gap (donut hole) which was formerly stage 3 Medicare prescription pricing. Instead it has been replaced by a $2,000 per year maximum copay amount. Once you have reached that maximum your co-pays will be $0 for your medications listed on your plans formulary for the remainder of that calendar year.
How can I select the right healthcare company and representative to work with?
Answer: You should plan to look at all available plans in your area and find a broker who is licensed with several products so they can help you compare your options and costs. Check with your friends, relatives, neighbors, or coworkers for a referral to an agent that they worked with that did well by them. You may also check with your local senior center as many agents advertise or offer educational seminars there.
How can I save money on my Medicare Supplement?
Answer: You may switch to a lower cost supplement plan offered in your area. An example of this might be switching from a supplement G to a supplement N. You may explore discounts available such as same household discounts. Or you may want to consider moving from a supplement plan to a Medicare Advantage plan with lower upfront costs.
Will I be penalized if I do not enroll in Medicare when I turn 65?
Answer: Late enrollment penalties only apply if you do not enroll in Medicare parts A and B within 3 months after you turn 65 or within 63 days of your employer health coverage ending if you continue to work and are covered by the employer for health insurance after the age of 65.